Making conscious individual choices regarding improvement in ones health is a function of the level of education the surrounding social and political culture and the level of information Health insurance coverage in most countries consists of a mix of publicly funded and private health care sy ID: 933781
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Slide1
Managing Health Risks
Health, both physical and mental, are determined by a combination of personal risk choices, and levels of prevention and remediation
Making conscious individual choices regarding improvement in one’s health is a function of the level of education, the surrounding social and political culture, and the level of information
Health insurance coverage in most countries consists of a mix of publicly funded and private health care systems.
Health care is strongly affected by conditions of incomplete and often asymmetric information, which provides a foundational justification for public sector intervention
To the extent that health care is “free” to the individual user, there is less of an incentive to adopt prudential health care practices, and instead to rely on public and private health insurance to cover remedial treatment
Designing effective public health care choices depends in the final analysis on the choice of economic incentives and the extent to which they are structured in a credible and transparent fashion to users.
Slide2Chronic, epidemic, and pandemic diseases in historical perspective
Chronic diseases
– organ failure (heart, liver, kidney), sickle cell anemia, cancer, AIDS, and tuberculosis are significant diseases. Some fatalities are due to genetic inheritance while others are due to lifestyle choices (smoking, drinking, inadequate exercise, lack of a healthy diet). Chronic diseases are mostly non-infectious, though some such as tuberculosis, and AIDS are infectious.
Epidemic diseases –infectious diseases that affect groups of population at specific moments in time (flu, malaria, typhoid, yellow fever, Ebola, SARS, and meningitis)Pandemic diseases – infectious diseases that strike whole populations at large regardless of the type or characteristics of the carrier or those infected.
Slide3Episodes of epidemic, and pandemic diseases in historical perspective
Plague of Athens
, 430 BC – 100,000 fatalities, coinciding with the Peloponnesian War between Athens and Sparta, and may have affected the outcome of the war.
Antonine Plague, 165-180 A.D. – estimates of as many as 5 million dead throughout the Roman Empire. St. Cyprian Plague, 250-271 AD. As many as 25,000,00 may have died throughout the Roman Empire.Plague of Justinian 527-565 AD – 600,000 fatalities.
The Black Death
1346-1353 – 25 million fatalities
Cocoliztli Epidemic
1545-1548 – 15 million fatalities in Mexico and Central America
Great Plague of London
1665-66 – 100,000 fatalities
1890 Influenza
– 1 million fatalities
1918 Influenza
– 100 million fatalities worldwide
AIDS 1981-Preant
– 35 million fatalities
Slide4The Coronavirus of 2020
The coronavirus was first documented in Wuhan, China in the fall of 2019
Similar to H1N1 viruses and given the name COVID-19 to reflect its difference with previous viruses of the same category
While a search for a vaccine began as early as December 2019, only starting in December have production versions by Pfizer and Moderna become commercially available.In the meantime, reliance on facial masks and social distancing, along with testing and contact tracing remain the most effective responses to the virus until universal vaccination has been accomplished.
Profiles of International, national, and regional areas reflect differences in policy consistency, implementation, and follow-up
Slide5Tracking The Coronavirus of 2020
Slide6The U.S. Accounts for between a Quarter and a Fifth of Global Coronavirus Cases
Slide7Tracking International Coronavirus Fatality Rates in 2020
Slide8Tracking Regional Coronavirus Cases in 2020
Slide9Tracking Regional Coronavirus Fatality Rates in 2020
Slide10Delmarva Coronavirus Cases in 2020
Slide11Tri-State Shares of Coronavirus Cases in 2020
Slide12Delmarva State Shares of Coronavirus Cases in 2020
Slide13Delmarva Coronavirus Fatality Rates in 2020
Slide14The Case Frequency Impact of Coronavirus on Minorities
Slide15The Impact of Coronavirus on Minorities
Slide16The Population Age Impact of Coronavirus Fatalities
Slide17The Gender Impact of Coronavirus Fatalities
Slide18Assessing the Impact of Coronavirus Fatalities
Slide19Assessing the Impact of Coronavirus Fatalities
The United States has the highest single number of COVID cases and fatalities, accounting for betwe3n 20 and 25 percent of the total of each since records were kept in March, 2020
Variations in international COVID case shares reflect a function of public policies to contain the virus – testing, tracing, face mask wearing, social distancing, and accelerated development and distribution of effective vaccines.
Maryland and Delaware fatality rates exceed those in the U.S. and the world average though lately at a lower rate. Overall fatality rates have been declining as responsive measures have been put into place.
Slide20Assessing the Impact of The Coronavirus, continued
Though smaller in population, Maryland has more cases than Virginia.
Maryland Eastern Shore counties have a dominant share of COVID cases on Delmarva
Newcastle, Sussex, and Kent counties in Delaware have higher case rates than for other counties on Delmarva.
Northampton county, Virginia and Kent County, Maryland have higher fatality rates than for Delmarva as a whole
COVID cases fall disproportionately on African-Americans and Hispanic origin residents, as do fatalities
COVID fatalities fall disproportionately among the elderly
COVID cases fall roughly equally between Men and Women, as do fatalities.
Slide21The Costs of Delay and Accountability are Substantial
Slide22Health Care Expenditure Share of U.S. GDP
Slide23International Health Care Expenditure and Life Expectancy
Slide24U.S. Health Care Expenditure by Financing Source
Slide25Sources of U.S. Health Care Financing
Slide26Evolution of U.S. Health Care Funding Sources
Slide27The Need for a Comprehensive Science-based Health Care Strategy for Sustainable Health
While there do not appear to be significant differences between countries with more centralized than decentralized government, there are differences in terms of the extent to which government designs and implements an effective national strategy.
China, where the COVID-19 virus is thought to have originated, has implemented severe lockdowns to bring infections under control. Elsewhere, countries are less governed by authoritarian regimes, thereby complicating the articulation of effective strategies
In Japan, and South Korea, along with India, more democratic institutions have prevailed in helping to contain the spread of the virus. It is in these countries where effective strategies might provide models for application elsewhere.In all cases, a combination of economic incentives and a coherent national strategy built on inclusion and democratic transparency are keys to success, a framework thus far eluding many western countries.
Expanding public financing of health care without efforts to address costs will not reduce the rising share of GDP devoted to health care. The ACA addressed the use of markets to provide greater insurance coverage at lower rate through health exchanges
While the ACA expanded insurance coverage, it did not address health care costs for prescription drugs and related treatment services, and at the same time did not place emphasis on preventive health care.
The lack of health care insurance coverage mobility is one factor that reduces per capita growth in GDP. The ACA did not address this issues, though the single payer option did.